Analysis of characteristics of lung function trajectory in long-term treatment and management of children with asthma

doi:10.3969/j.issn.1006-7795.2022.06.019

Abstract

Abstract: Objective To analyze the trajectory characteristics of pulmonary function in 5 to 17 years old children with asthma after long-term treatment management in a single center and explore the factors influencing pulmonary function trajectories and to identify early persistent pulmonary function impairment phenotypes. Methods This is a retrospective cohort study. We enrolled 5 to 17 years old children with bronchial asthma who were diagnosed in the Department of Allergy, Beijing Children's Hospital from November 1,2018 to November 30,2020, and have been treated for 3 years or more. The clinical information was collected, which included demographic characteristics, medical history, steps of control treatment drugs, assessment of asthma control level and allergen results. The result of pulmonary function tests with maximum expiratory flow-volume curve (MEFV) was retrospectively analyzed. The parameters contain the percentage of the forced expiratory volume in the first second to the predicted value (FEV1%pred), forced vital capacity as a percentage of predicted value (FVC%pred), forced expiratory volume in one second to forced vital capacity (FEV1/FVC), the percentage of the maximum expiratory flow to the predicted value (PEF%pred), and the percentage of the maximum mid-expiratory flow to the predicted value (MMEF%pred). The pulmonary function data after 2-year managment were sorted out for trajectory analysis with univariate analysis and multivariate Logistics regression analysis. Results Out of 157 children, a total of 471 cases of pulmonary function data were used for trajectory analysis. FVC%pred, FEV1%pred and FEV1/FVC were divided into 2 types of trajectories: low trajectory and high trajectory. The trajectories fitted by PEF%pred and MMEF%pred were not statistically significant (P>0.05). Multivariate Logistic regression analysis showed that the risk factor for the low trajectory of FVC%pred is control instability (OR=4.878; 95%CI: 1.714-13.882). The risk factor for the low trajectory of FEV1%pred was the first abnormal lung function (OR=4.911; 95%CI: 2.137-11.287), and those for the low trajectory of FEV1/FVC was first-time abnormal lung function(OR=18.472;95%CI:5.182-65.850)and males (OR=3.774; 95%CI: 1.125-12.658). Conclusions The males, the first analyzable abnormal lung function and unstable control was risk factors that was prone to result in low trajectories.

Key words: children, bronchial asthma, management, pulmonary function, trajectory analysis

CLC Number:

R725.6

Li Ang, Huang Huijie, Yang Shiqing, Hou Xiaoling, Xiang Li. Analysis of characteristics of lung function trajectory in long-term treatment and management of children with asthma[J]. Journal of Capital Medical University, 2022, 43(6): 940-947.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2022.06.019

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2022/V43/I6/940

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